TY - JOUR
T1 - Triglycerides Paradox Among the Oldest Old
T2 - “The Lower the Better?”
AU - Lv, Yue Bin
AU - Mao, Chen
AU - Gao, Xiang
AU - Yin, Zhao Xue
AU - Kraus, Virginia Byers
AU - Yuan, Jin Qiu
AU - Zhang, Juan
AU - Luo, Jie Si
AU - Zeng, Yi
AU - Shi, Xiao Ming
N1 - Funding Information:
Financial Disclosure: This work was supported by National Natural Sciences Foundation of China (71233001 and 71490732 to Zeng and 81573247 to Shi), the US National Institute on Aging (2P01AG031719 to Zeng and 5P30AG028716 Kraus), the United Nations Fund for Population Activities.
Funding Information:
This work was supported by National Natural Sciences Foundation of China (71233001 and 71490732 to Zeng and 81573247 to Shi), the US National Institute on Aging (2P01AG031719 to Zeng and 5P30AG028716 Kraus), the United Nations Fund for Population Activities. The authors have no conflicts of interest to report. Lv, Mao, Gao, Yin, Kraus, Yuan, Zhang: data analysis and interpretation, preparation of manuscript. Shi, Zeng: study concept and design, acquisition of subjects and/or data, preparation of manuscript. Luo: acquisition of subjects and/or data, preparation of manuscript. All authors: revision of manuscript for important intellectual content, approval of final draft. The sponsors had no role in study design, implementation of study, data collection, data interpretation, or preparation of manuscript.
Publisher Copyright:
© 2019 The American Geriatrics Society
PY - 2019/4
Y1 - 2019/4
N2 - OBJECTIVES: Currently, most treatment guidelines suggest lowering hypertriglyceridemia of any severity, even in elderly individuals. However associations of serum triglycerides (TGs) with adverse health and mortality risk decrease with age, it remains unclear among the oldest old (aged 80 years and older). The study was to investigate the relationship of serum TG concentrations with cognitive function, activities of daily living (ADLs), frailty, and mortality among the oldest old in a prospective cohort study. DESIGN: Longitudinal prospective cohort study. SETTING: Community-based setting in longevity areas in China. PARTICIPANTS: A total of 930 (mean age = 94.0 years) Chinese oldest old. MEASUREMENTS: The TG concentrations were measured at baseline survey in 2009. Cognitive function, ADLs, frailty, and mortality were determined over 5 years of follow-up. Cox proportional hazards models and competing risk models were performed to explore the association, adjusting for potential confounders. RESULTS: Each 1-mmol/L increase in TGs was associated with a nearly 20% lower risk of cognitive decline, ADL decline, and frailty aggravation during the 5 years of follow-up. Consistently, higher TGs (each 1 mmol/L) was associated with lower 5-year all-cause mortality after fully adjustment (hazard ratio [HR] = 0.79; 95% confidence interval [CI] = 0.69-0.89). Nonelevated TG concentrations (less than 2.26 mmol/L) were associated with higher mortality risk (HR = 1.72; 95% CI = 1.22-2.44), relative to TGs of 2.26 mmol/L or more. We observed similar results regarding TG concentrations and mortality in 1-year lag analysis and when excluding participants with identified chronic disease. CONCLUSION: In the oldest old, a higher concentration of TGs was associated with a lower risk of cognitive decline, ADL decline, frailty aggravation, and mortality. This paradox suggests the clinical importance of revisiting the concept of “the lower the better” for the oldest old. J Am Geriatr Soc 67:741–748, 2019.
AB - OBJECTIVES: Currently, most treatment guidelines suggest lowering hypertriglyceridemia of any severity, even in elderly individuals. However associations of serum triglycerides (TGs) with adverse health and mortality risk decrease with age, it remains unclear among the oldest old (aged 80 years and older). The study was to investigate the relationship of serum TG concentrations with cognitive function, activities of daily living (ADLs), frailty, and mortality among the oldest old in a prospective cohort study. DESIGN: Longitudinal prospective cohort study. SETTING: Community-based setting in longevity areas in China. PARTICIPANTS: A total of 930 (mean age = 94.0 years) Chinese oldest old. MEASUREMENTS: The TG concentrations were measured at baseline survey in 2009. Cognitive function, ADLs, frailty, and mortality were determined over 5 years of follow-up. Cox proportional hazards models and competing risk models were performed to explore the association, adjusting for potential confounders. RESULTS: Each 1-mmol/L increase in TGs was associated with a nearly 20% lower risk of cognitive decline, ADL decline, and frailty aggravation during the 5 years of follow-up. Consistently, higher TGs (each 1 mmol/L) was associated with lower 5-year all-cause mortality after fully adjustment (hazard ratio [HR] = 0.79; 95% confidence interval [CI] = 0.69-0.89). Nonelevated TG concentrations (less than 2.26 mmol/L) were associated with higher mortality risk (HR = 1.72; 95% CI = 1.22-2.44), relative to TGs of 2.26 mmol/L or more. We observed similar results regarding TG concentrations and mortality in 1-year lag analysis and when excluding participants with identified chronic disease. CONCLUSION: In the oldest old, a higher concentration of TGs was associated with a lower risk of cognitive decline, ADL decline, frailty aggravation, and mortality. This paradox suggests the clinical importance of revisiting the concept of “the lower the better” for the oldest old. J Am Geriatr Soc 67:741–748, 2019.
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U2 - 10.1111/jgs.15733
DO - 10.1111/jgs.15733
M3 - Article
C2 - 30628728
AN - SCOPUS:85059845698
VL - 67
SP - 741
EP - 748
JO - Journal of the American Geriatrics Society
JF - Journal of the American Geriatrics Society
SN - 0002-8614
IS - 4
ER -